The Gateway Dental Reference Guide is designed to provide you and your office staff with information about United Concordia’s policies and procedures used to administer dental benefits for Gateway Health Plan ® 18. Your plan should be as specific as possible by answering all of the following questions. The purpose of this manual is to provide Gateway Health participating providers with a guide to the Secure Messaging application within Gateway Health’s Provider Portal. The manuals include all-provider and provider-specific pages. Primary Care Physicians (PCPs) are those physicians who accept the responsibility of providing and/or coordinating the health care needs of any Gateway member who chooses that physician. 13. Providers will be able to access the upgraded application beginning 08/01/2016. How? Prior Authorizat 1. Pre-requisite This functionality is available for Gateway Health Participating providers with access to NaviNet. 14. TTY users call 711 or 1-800-654-5984. Click Menu on top left, select Administrative Guides and Manuals, then Community Plan Care Provider Manuals, select state. 12.Gateway Health has expressed interest in using AAA learning and development centers for training staff for Community HealthChoices (CHC.) you go to the doctors, hospital or any other health care provider. As an example, let’s use these questions to take a look at how we could plan a small step towards losing weight: a. Go to the Provider Manual web page to view individual topics. This manual applies to all EmblemHealth plans and is an extension of your Provider Agreement. General Prior Authorization Requirements 2. Call us if you have questions about which provider manual you should use. United Concordia and Gateway realize that the success of our partnership is dependent upon communication and educational processes. Accordingly, Gateway Health has facilitated a variety of health benefit plan strategies to achieve employers’ goals in terms of cost, access to providers, employees’ preferences and administrative requirements. You will also get an ACCESS or EBT card. Environmental Lead Testing19. 16. Easily find information in this manual using B. It also details best practices for interacting with our plans and helping our members navigate their health care. The purpose of this manual is to guide Gateway Health participating providers who wish to electronically submit authorization request forms. Provider Manual - Gateway Health. Pre-requisite This functionality is available for Gateway Health Participating providers with access to NaviNet. ... 801 Gateway Blvd., Suite 100 South San Francisco, CA 94080. It includes detailed information about your administrative responsibilities, and contractual and regulatory obligations. Each Gateway Health Client Employer has different goals and needs. They intend on delegating SC requirements by state and enforcing quality standards from Gateway. • physicians, health care professionals, facilities and A different Community Plan manual: go to UHCprovider.com. If your Gateway Health member card is lost or stolen, call Member Services at 1-800-392-1147. 4) Specific Plan Next decide specifically what you are going to do differently everyday to achieve your goal. 15. Time Frames for Notice of Decisions Behavioral Health Outpatient Services: Prior Authorization Requirements (PDF) Check the Status of an Authorization Online (PDF) Filtering Authorizations on the Secure Provider Portal (PDF) How to Use the Pre-Authorization Tool (PDF) Health Details: the participation status of a provider with the applicable payor, plan or Gateway before referring a patient.Primary Care Physicians . 17. 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